Effectiveness and safety of submaximal angioplasty and stenting for patients with severe carotid artery stenosis before CABG / 中华胸心血管外科杂志

Objective:To investigate the feasibility and safety of submaximal balloon dilation and to perform small-diameter stent for symptomatic carotid artery severely stenosis before coronary artery bypass grafting(CABG).Methods:From January 2016 to December 2019, 30 patients of the Department of Neurointervention in Beijing Anzhen Hospital with symptomatic carotid artery stenosis(≥70%) and the left main trunk or triple-vessel of coronary artery disease were analyzed retrospectively. General information, clinical characteristics, and imaging data of all cases were collected. All patients underwent submaximal balloon dilation and small-diameter stent implantation. Preoperative comorbidities or risk factors included hypertension 23 cases(76.7%), diabetes 10 cases(33.3%), hyperglycemia 14 cases(46.7%), moking 13 cases(43.3%). Left main trunk disease 6 cases(20.0%), three-vessels disease 24 cases(80.0%), mitral regurgitation 1 case(3.3%), stable angina 25 cases(83.3%), myocardial infarction 8 cases(26.7%), cerebral infarction 24 cases(80.0%) and transient ischemia attack(TIA) 6 cases(20.0%) caused by ipsilateral carotid artery stenosis. The median National Institutes of Health Stroke Scale(NIHSS) score was 2(0-3), and the median modified Rankin Scale(mRS) score was 1(0-1) before the operation. The mean interval between carotid artery intervention and CABG was(23.4±8.2)days.Results:29 cases(96.7%, 29/30) underwent CAS-CABG operation successfully. In one case of carotid artery extreme tortuosity, the emboli protective device could not place the distal carotid artery. In the operative procedure, 27 cases(90.0%, 27/30) underwent with 3mm diameter balloon, only 3 cases(10.0%) with 3 mm balloon after pre-dilatation with 2 mm diameter balloon because of severely high-grade stenosis(99%). 25 cases(83.3%) with 7mm diameter stents and 5 cases(16.7%) with 6 mm diameter stents, including 22 cases(73.3%) with a closed-cell stent and 8 cases(26.7%) with an open-cell stent. In the perioperative period, the heart rate of two patients was lower than 50 BPM during operation and returned to normal after using atropine immediately. Another patient presented with chest tightness during interventional therapy. TNI elevation was examined urgently. After oxygen inhalation and intravenous infusion of Nitroglycerin, the patient's symptoms improved rapidly. No cardiac and cerebrovascular complications occurred during the perioperative period of CABG, no cardiac-related complications occurred within 30 days of follow-up, one case of TIA and 1 case of cerebral infarction. After intensive anti-platelet aggregation and lipid-lowering treatment, two patient's symptoms improved. There were no death cases in all patients during carotid artery interventional therapy, perioperative CABG and 30-day follow-up. Thirty days later, we performed a clinical follow-up of 23 cases, median 4.5(3.0-7.9) months, mRS Score Median 1(0-1). One patient presented with TIA, any patient had no symptoms of the cardiac or nervous system. Image follow-up of 17 cases, median 3.5(2.8-4.5) months, carotid artery ultrasound showed in-stent restenosis(stenosis rate>50%) in 1 case, the patient was asymptomatic restenosis, continue treatment of aggressive anti-platelet and lipid-lowering drugs.Conclusion:Submaximal balloon dilation and performing small-diameter stent for symptomatic carotid artery severely stenosis before CABG is safe and feasible, which could not only reduce the incidence of vagus reflex resulted in acute coronary syndrome during carotid artery stenosis intervention but also morbidity of acute ischemic stroke events during CABG.

Finite element simulation of stent implantation and its applications in the interventional planning for hemorrhagic cardio-cerebrovascular diseases / 生物医学工程学杂志

Numerical simulation of stent deployment is very important to the surgical planning and risk assess of the interventional treatment for the cardio-cerebrovascular diseases. Our group developed a framework to deploy the braided stent and the stent graft virtually by finite element simulation. By using the framework, the whole process of the deployment of the flow diverter to treat a cerebral aneurysm was simulated, and the deformation of the parent artery and the distributions of the stress in the parent artery wall were investigated. The results provided some information to improve the intervention of cerebral aneurysm and optimize the design of the flow diverter. Furthermore, the whole process of the deployment of the stent graft to treat an aortic dissection was simulated, and the distributions of the stress in the aortic wall were investigated when the different oversize ratio of the stent graft was selected. The simulation results proved that the maximum stress located at the position where the bare metal ring touched the artery wall. The results also can be applied to improve the intervention of the aortic dissection and the design of the stent graft.

Analysis of CT features of early asymptomatic active pulmonary tuberculosis in adolescence / 实用放射学杂志

Objective To analyze the CT features in the early stage of asymptomatic active pulmonary tuberculosis (PTB)in adolescence after PTB outbreak.Methods After PTB outbreak in a boarding school of a certain county in northern Jiangsu province,the clinical data, X-ray and CT findings of 47 cases with active PTB were analyzed retrospectively and compared with CT findings after treatment.Results In 47 cases,the incidence of male was higher than that of female,and 27 cases were negative on chest X-ray.The difference of X-ray and CT detection rate in the early stage of active PTB was statistically significant (P<0.001).Of 47 cases,46 patients had pulmonary parenchymal lesions and 1 had pleural effusion on CT.The lesions were found on 58 lobes and 60 lung segments,and 35 cases demonstrate lesions on the upper lobes,22 cases on the lower lobes,1 case on the middle lobe.CT images showed tree-in-bud opacities (68.1%),micronodules (89.4%) and consolidation (21.3%).All of patients got better after antituberculous therapy.Conclusion Active PTB should be considered first when CT scan shows micronodules or tree-in-bud signs in adolescences with PTB exposure.

Study on Quality Standard of Oleanolic Acid Dripping Pills / 中国药房

OBJECTIVE:To establish the quality standard of Oleanolic acid dripping pills. METHODS:The property of the preparation was identified,and weight difference and dissolution time limit were detected. UPLC method was adopted to determine the content of oleanolic acid in the preparation. The determination was performed on ACQUITY UPLC BEH C18 column with mo-bile phase consisted of acetonitrile-water (70:30,V/V) at the flow rate of 0.30 mL/min. The detection wavelength was set at 206 nm,the column temperature was 30 ℃,and the sample was 5 μL. RESULTS:The characteristics of the preparation was significant;weight difference ranged 37.62%-46.56%;dissolution time limit was 24 min. Linear range of oleanolic acid ranged 0.006-0.06 mg/mL (r=0.9998). RSDs of precision,stability and reproducibility tests were all lower than 2.0%. The recoveries were 99.34%-100.40%(RSD=0.4%,n=6). CONCLUSIONS:Established standard can be used for quality control of Oleanolic acid dripping pills.

Biocompatibility and security of calcium sulfate bone substitutes / 中国组织工程研究

BACKGROUND:It is a great potential study that calcium sulfate product loaded with antibiotics is developed, but this product is not systematicaly studied and its biocompatibility and security need to be further studied. OBJECTIVE:To evaluate the biocompatibility and safety of vancomycin- or gentamicin-loaded calcium sulfate bone. METHODS: (1) Hemolysis test: vancomycin-loaded, gentamicin-loaded calcium sulfate extracts, double distiled water and saline were added into rabbit anticoagulant blood samples. (2) Micronucleus test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts, cyclophosphamide and normal saline solution were intraperitonealy injected to mice, respectively. (3) Acute toxicity test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts, and normal saline solution were intraperitonealy injected to mice, respectively. (4) Pyrogen test: the mice were injected vancomycin-loaded and gentamicin-loaded calcium sulfate extractsvia the ear vein. (5) Intradermal stimulation test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts were respectively injected into the unilateral spine of rabbits, respectively. (6) Intramuscular implantation test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts were respectively injected to the dorsal muscle of rabbits. (7) Intraosseous implantation test: vancomycin-loaded and gentamicin-loaded calcium sulfate were implanted into the necrotic femoral bone of rabbits. RESULTS AND CONCLUSION:Both vancomycin-loaded and gentamicin-loaded calcium sulfate products, which have no hemolytic reaction, genetic toxicity, acute toxicity, pyrogen reaction and skin irritation, are considered to have good biocompatibility and safety.

Analysis of the shape and hemodynamic characteristics of the ruptured posterior communicating artery minimal aneurysms / 中国脑血管病杂志

Objective To investigate the shape and hemodynamic characteristics of the ruptured posterior communicating artery minimal aneurysms. Methods The clinical data of 42 patients with ruptured posterior communicating artery minimal aneurysm (the maximum diameter < 3 mm,11 ruptured aneurysms and 31 unruptured aneurysms)were collected retrospectively. Three-dimensional DSA shapes of the aneurysms were assessed,and the hemodynamic parameters of the aneurysms were calculated according to their computer simulation models. Results (1)The multiple aneurysms were more common in the unruptured group than those in the ruptured group (58. 1% [18/ 31]vs. 9. 1% [1/ 11]). There was significant difference,P = 0. 006 ). (2 )The complex flow pattern was more common in the ruptured group (63. 6%[7 / 11]vs. 6. 5% [2 / 31],P < 0. 01)and also the changed flow pattern (45. 5% [5 / 11]vs. 3. 2% [1 / 31),P = 0. 003). (3)The median aneurysm wall shear stress of the ruptured group was 0. 74 (0. 52,0. 86)and that of the unruptured group was 1. 03(0. 83,3. 64). There was significant difference between the 2 groups (P =0. 008). Conclusion The unruptured minimal aneurysms are common in patients with multiple aneurysms. Active surgical intervention is recommended for the posterior communicating artery minimal aneurysms with low wall shear stress,complex and change flow.

Curative effect evaluation of senile osteoporotic vertebral compression fractures with balloon kyphoplasty / 局解手术学杂志

Objective To study the curative effect and safety of senile osteoporotic vertebral compression fractures with balloon ky-phoplasty. Methods The clinical data of 80 patients in our hospital during July 2008 to July 2012 with senile osteoporotic vertebral compres-sion fractures were analysed retrospectively. And the clinical effect was evaluated by observing the charges of visual analog scale (VAS), height of vertebral bodies and Cobb’ s angle, the quality of life score in patients respectively before and after operation. Results The pain of the patients were controlled effectively after operation, and the patients had significant and sustained improvement in anterior and midline ver-tebral body height after operation, with (56. 02 ± 12. 08) % and (58. 19 ± 13. 11) % before preoperation respectively, and (72. 10 ± 16. 19) % and (78. 33 ± 19. 02) % after surgery respectively. VAS score reduced from (8. 31 ± 1. 22) to (1. 65 ± 0. 33) after surgery;Cobb’s angle reduced from (24. 12 ± 3. 28)° to (13. 56 ± 2. 05)° after operation. The differences of the frontal height and flange height, VAS scores, and Cobb’s angle before and after operation were statistically significant (P<0. 05). The incidence of complications reduced from 23. 75% to 1. 25% after operation, which indicates significant difference (P<0. 01). According to QLQC-30 quality of life score, the postoperative life of patients were much better than that of the preoperative life, and the difference of all statistical index were of statistical significance (P<0. 05). Conclusion Balloon kyphoplasty in the treatment of senile osteoporotic vertebral compression fractures has signifi-cant effect and high safety, it should be popularized and applied in clinical.

Protective effect of penehyclidine hydrochloride on secondary lung injury after traumatic shock in rats / 中华创伤杂志

Objective To observe the interfering effect of different doses of penehyclidine hydrochloride (PHC) on the mRNA expressions of nuclear factor kappa B (NF-κB) and inducible nitric oxide synthase (iNOS) in the lung tissue of rats with traumatic shock so as to investigate the protective role of PHC in secondary long injury following traumatic shock and the underlying mechanism.Methods The traumatic shock model was established.A total of 104 Wistar rats were randomly divided into four groups:control group,shock group,low dose PHC group ( P1 group) and high dose PHC group ( P2 group).At the beginning of resuscitation,the rats in P1 and P2 groups were given transjugular intravenous injection of 2 ml/kg isotonic saline containing 0.15 mg/kg and 0- 45 mg/kg PHC respectively,while the rats in shock and control groups were injected only isometric isotonic saline.The rats in the four groups were killed at 2 h,6 h,12 h and 24 h after resuscitation respectively to detect the mRNA expressions of NF-κB and iNOS by using RT-PCR and determine the lung wet/dry weight (W/D) ratio,lung permeability index (LPI) and lung injury score (LIS).Results The mRNA expressions of NF-κB and iNOS,lung W/D ratio,LPI and LIS at all the time intervals in the shock,P1 and P2 groups were all significantly increased as compared with those in the control group (P＜0.05).Howerver,the P2 group showed significant reduction in aspects of the mRNA expressions of NF- κB and iNOS,lung W/D ratio,LPI and LIS at all time points and P1 group also had significant decrease regarding the mRNA expressions of NF-κB and iNOS,lung W/D ratio at2 h,6 h,and LPI and LIS at 2 h,6 h,12 h,as compared with the shock group.Meanwhile,P2 group showed evident decrease at 6 h concerning the mRNA expressions of NF-κB and iNOS,lung W/D ratio,LPI and LIS as compared with P1 group (P ＜ 0.05 ).Conclusions PHC,especially at a large dosage,can significantly mitigate the long injury secondary to traumatic shock,and the mechanism may be associated with the inhibition of mRNA expressions of NF-κB and iNOS.

Expression of transforming growth factor-β in local bony callus in traumatic brain injury combined with extremity fracture in rats / 中华创伤骨科杂志

Objective To investigate gene expression of transforming growth factor-β(TGF-β) in local bony callus in traumatic brain injury combined with extremity long bone fracture in rats.Methods Eighty male SD rats were randomized into 2 even groups: the experimental group were models of traumatic brain injury combined with extremity bone fracture and the control group were models of simple extremity bone fracture. Samples of bony callus were harvested at 1, 2, 3, and 4 weeks in both groups, each time from 10rats respectively, for detection of gene expressions of TGF-β by reverse transcription PCR techniques.Results Levels of gene expression of TGF-3 in local bony callus in the experimental group were significantly higher than in the control group at one week ( P ＜ 0. 05); but significantly lower at 3 weeks( P ＜ 0. 05) .Peak values occurred at 2 week in both groups, though, significantly higher than at other times, there was no significant difference between the 2 groups( P ＞ 0. 05) .Conclusion Changes in gene expression of TGF-β in local bony callus in traumatic brain injury combined with extremity long bone fracture indicate that TGF-β may play a role in the process of increased fracture healing.

Estradiol and prolactin levels in young females with cerebral trauma combined with extremity long tubular bone fracture / 中华创伤骨科杂志

Objective To investigate the estradiol (E2) prolactin (PRL) levels in young females with cerebral trauma combined with extremity long tubular bone fracture. Methods E2 and PRL were detected in 39 young females with cerebral trauma combined with extremity long tubular bone fracture (experimental group) and 42 young females with just extremity long tubular bone fracture (control group) at 1 to 3, 5 to 7, 10 to 14, 28 to 30, and 56 to 60 days after injury. Results E2 levels in the experimental group were significantly higher than in the control group at 1 to 3, 5 to 7, 10 to 14, and 28 to 30 days after injury (P < 0.05), but there was no significant difference in the E2 level between the 2 groups at 56 to 60 days after injury (P > 0.05) . Compared with 1 to 3 days, the E2 level was significantly decreased in the experimental group at other time points (P < 0. 05), while there was no significant difference in the E2 level in the control group among each time point (P > 0. 05). PRL level in the experimental group was significantly higher than in the control group at all time points. In particular, the PRL level in the experimental group was significantly increased at 5 to 7, 10 to 14 and 28 to 30 days after injury, compared with that at 1 to 3 days after injury (P<0.05), but there was no significant difference in the PRL level between 56 to 60 days and 1 to 3 days (P > 0. 05). Additionally, the PRL level did not change in the control group at all time points (P > 0.05). Time of fracture healing in the experimental group was significantly shorter than in the control group, while the time of hospital stay in the experimental group was significantly longer than in the control group (P<0.05). Conclusion E2 and PRL levels increase remarkably in the young females with cerebral trauma combined with extremity long tubular bone fracture at an early onset stage.

Combined Stent and Coils for the Treatment of Middle Cerebral Artery Bifurcation Wide-necked Aneurysms: 15 Cases Report / 中国康复理论与实践

@#Objective To summarize the technique of stent combined with coils to treat middle cerebral artery bifurcation wide-necked aneurysms. Methods 15 patients were reported. Results 11 of 15 aneurysms were completely occluded and 4 were incompletely (>95%) occluded. Transient ischemia of cerebral occurred in a case. 8 aneurysms were followed up for 6～12 months, 1 presented neck remnant growth. Conclusion It is satisfied to use the stent combined with coils to treat middle cerebral artery bifurcation wide-necked aneurysm, which may protect the parent artery.

Protective mechanisms of glycine against the secondary liver injury of rats after taumatic shock / 中华创伤杂志

Objective To investigate the effects of glycine on the expression of HSP70 and TNF-α mRNA in the liver tissue of rats with traumatic shock and explore the protective mechanism of glycine a-gainst secondary liver injury after traumatic shock. Methods The traumatic shock model was established and 120 Wistar rats were divided randomly into three groups: treatment group, shock group and control group. At the beginning of resuscitation, the rats in the treatment were injected with 0.5 ml isotonic saline containing 100 mg/kg glycine, those rats in the shock group were injected only with 0.5 ml isotonic saline. The rats in three groups were killed at 3, 6, 12, 24 and 48 hours after resuscitation respectively. The ex-pression of HSP70 and TNF-α mRNA in the liver tissue were detected by RT-PCR, pathological changes were observed and serum ALT and AST were measured. Results The expressions of HSP70 and TNF-α mRNA in the liver tissue of rats in the shock group began to increase at 3 hours and both reached the peak value at 6 hours after resuscitation, but the expression of HSP70 mRNA in the treatment group reached the peak value at 12 hours after resuscitation. Compared with the control group, the expression of HSP70 mR-NA in the treatment group increased significantly and that of TNF-α mRNA decreased siganicantly, serum ALT and AST decreased and pathological damage was relieved significantly (all P < 0.05). Conclusion By enhancing the expression of HSP70 mRNA and decreasing the expression of TNF-α mRNA, glycine may play a protective role against the secondary damage of liver after traumatic shock.

A finite element model based on medical image for evaluating biomechanical stability of percutaneous vertebroplasty / 中国组织工程研究

BACKGROUND: Researches on vitodynamics present that percutaneous vertebroplasty (PVP) can strengthen hardness and intension of single osteoporosis vertebral body after injection of bone cement; however, the infused volume and site of bone cement for maintaining mechanical stability of vertebral body should be further studied.OBJECTIVE: A numerical calculation method on finite element models (FEM) for biomechanical analysis has been developed, while a boundary condition describing the relative L1 -L2 displacement is imposed on the FEM to account for three-dimensional physiological states.DESIGN: Non-randomized control study.SEITING: Beijing Neurosurgical Institute.MATERIALS: One female patient aged 54 years with compressibility fracture at lumbar vertebrae L1-L2 induced by osteoporosis was diagnosed with CT examination, and the patient was told the fact. Based on CT scanning before and after PVP, 90 serial sections with the thickness of 1 mm were obtained and the size of each pixei was 0.33 mm.METHODS: The experiment was carried out Beijing Neurosurgery Institute from October 2005 to June 2006. ①Establishment of three-dimensional FEM: Integrating the anatomical structure from the spine CT and MRI image of a patient, a novel three-dimensional geometric model of lumbar functional spinal units (FSUs) has been built. Meanwhile, 90 serial sections were obtained to exchange data of CT sections and divide imagings. Based on the geometric model, two kinds of three-dimensional FEM of L1-L2 segments for preoperative and postoperative vertebrae were created. ② Model evaluation: The lcad of (500 N, 1 000 N, 1 500 N, 2 000 N, 2 500 N) axial compression were applied to the superior surface of the model in the form of a uniformly concentrated lcad over all L1 superior surface nodes respectively. We could observe the stress distribution of L1-L2 segment by applying the load and clue on the high stress concentration region as the most likely areas fracture.MAIN OUTCOME MEASURES: ① Changes of displacement, stress and strain distributions of FEM at L1-L2 segment of lumbar vertebrae under various loads; ② Effect of increase of bone cement volume on displacement, stress and strain distribution.RESULTS: ① The increase in displacement, stress and strain of FE model with the increase of loading in the postoperarive cases. The tendency was approximately linear which also illustrates the spine have flexible biomechanical characteristics. The region was a common place for injures due to loading. The magnitude of stress in the intervertebral disc depended on the proportion of load applied to the superior surface of the motion segment. The heavier the lcad was, the stronger the stress was. ② With the increase of stress on intervertebral disc, the increasing volume of bone cement could induce transfusion of load of nearby vertebral body.CONCLUSION: Building three-dimensional FEM of L1-L2 segments for preoperative and postoperative PVP can explain three-dimensional physiological status of vertebral body based on calculating relative shift of L1-L2 segment of lumbar vertebrae. Meanwhile, simulative calculation can clearly express distribution of stain and stress and preoperative and postoperative deformity of vertebral body.

Percutaneous Permeability of Miconazole Nitrate Creams from Four Manufacturers in Vitro / 中国药房

FJ, with 9.7 times difference between the highest and the lowest. CONCLUSION: Prepared with different base materials, the permeation ability of of the preparation will be different.

Effect of Four Penetration Enhancers on Percutaneous Absorption of Diphenhydramine Hydrochloride / 中国药房

glycerol,and the best penetrable concentrations for it were 0.5%,0.5% and 0.2%,respectively.No obvious penetration efficacy was noted for glycerol.CONCLUSIONS: 4 kinds of penetrations enhances can increase the percutaneous absorption of DH under the certain concentration.

Neuroform Stent implantation for teatment of intracranial wide-necked aneurysms:preliminary outcome / 中国康复理论与实践

@# ObjectiveTo summarize the technique and preliminary outcome of Neuroform stent combined with Guglielmi detachable coil (GDC) to treat wide-necked intracranial aneurysms. Methods32 cases with aneurysms which underwent 32 endovascular procedures performed by using stent were retrospectively analyzed.The ratio of aneurysm neck/body is 1/2～1/1. Results24 aneurysms were completely occluded and other 8 were incompletely (>95%) occluded. Transient ischemia of cerebral occured in 2 cases. 14 aneurysms were followed up 0.5～1 year after. 2 aneurysms of them appeared neck remnant growth.ConclusionUsing Neuroform stent combined with GDC to treat wide-necked intracranial aneurysm may prevent the herniation of GDC into the artery and increase the outcome of wide-necked intacranial aneurysm.

The treatment of vertebral benign and malignant tumors with percutaneous vertebroplasty / 介入放射学杂志

Objective Vertebral benign and malignant tumors were intractable in the treatment. Previous treatment methods had their own deficiency. The introduction of percutaneous vertebroplasty brought a breakthrough in the treatment. The initial experience of the treatment of vertebral malignant and benign tumors with percutaneous vertebraplasty was analyzed in this clinical research.Methods and materials The treatment of seven cases of vertebral hemangiomas and 11 cases of vertebral malignant tumors were reported. Unipedicular or bipedicular approaches were used in 17 cases, and in one case of cervical hemangioma, the cervical anterior-lateral approach was adopted. 15-20% of bone cement was mixed and injected into the vertebral lesions and made to distribute and cast in the lesions. Results Good results were got in all the 18 cases. After 0.5-7ml of cement was injected into the lesions. The complete relief was got in 10 cases and sub-complete relief was achieved in 6 cases and medial relief was got in two cases. One to nine months of postoperative follow-ups found no recurrences.Conclusions The treatment of vertebral benign and malignant tumors with percutaneous vertebraplasty was mini-invasive, safe, and effective.

Comparison of cellulose acetate polymer and electrolytic detachable coils for treatment of canine aneurysmal models / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>Electrolytic detachable coils (EDC) have been the main embolic materials for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, the embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared.</p><p><b>METHODS</b>The canine aneurysmal models constructed by anastomosis of venous pouches were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow-ups were performed at 24-hour, 2-week, and 2-month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research.</p><p><b>RESULTS</b>The effect of embolization was significantly better with WEDC than that with CAP (chi2 = 5. 56, P < 0.05). Post-embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathological research showed that CAP mass could packed the aneurysms more densely than coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltration was prominently found in early stage after CAP-embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orifices of aneurysmal necks could be found in both groups 2 months after embolization. But parts of coils might be exposed outside endothelial layer.</p><p><b>CONCLUSIONS</b>EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of strong chemical corrosion and difficulty in control before it is widely used.</p>

Clinical Characteristics and Imaging Diagnosis of the Traumatic Carotid Cavernous Fistula(TCCF) with Hemorrhage / 实用放射学杂志

Objective To explore the clinical and imaging characteristics of traumatic carotid cavernous fistula(TCCF) with hemorrhage.Methods There were thirteen cases of TCCF underwent car accidents combined with epistaxis or intracranial hemorrhage between 1990 and 2000.Their clinical symptoms,CT,MR,and digital substract angiogram(DSA) were retrospectively analysed.Results There were special clinical and imaging characteristics in TCCF.Small amount of epistaxis and isolateral loss of sight might be found in cases with epistaxis at early stage,but delayed fatal and massive epistaxis occured at various time after trauma.Cranial base fracture and pseudoaneurysm were special imaging signs.In the TCCF cases with intracranial hemorrhage,prominent and tortuose cortical drainage veins might be found.And pseudoaneurysm at posterio-lateral wall of cavernous sinus might be another special imaging sign.Conclusion Small amount of epistaxis at early stage,cranial base fracture,pseudoaneurysm,prominence and tortuosity of cortical veins are characteristic diagnostic references for TCCF with hemorrhage.Emergent DSA examination at early stage should be regarded as a key step for diagnosis and treatment.

Short term therapeutic effect of embolizing carotid-cavernous sinus fistula by superior ophthalmic vein approaches / 眼科

Objective To investigate the therapeutic effect of embolizing carotid-cavernous sinus fistula(CCF) by superior ophthalmic vein(SOV) approaches.Design Retrospective case series.Participants 11 patients with CCF diagnosed by digital subtraction angiography(DSA) were failurers of traditional artery approaches.Methods All pathents were treated with embolizing carotid-cavernous sinus fistula by superor ophthalmic vein approaches.Main Outcome Measures visual acuity,exophthalmos,ocular movement,diplopia,conjunctival hyperemia,ocular fundus changes.Results Clinical cure was achieved in all 11 patients during follow-up for 1 week to 3 months.Six patients with symptoms of exophthalmos disappeared and five improved.8 cases with conjunctival hyperemia vanished and 3 cases relieved.The three patients with decreases of 8 visual acuity,among these one patient was normal and two improved.Intracalvarium strepitus and diplopia were all disappeared and ocular movement was normal.Conclusion Embolizing CCF by SOV is safe and effective when performed by a multidisciplinary team.